Zinc deficiency may be risk factor for development of herpes zoster: Case Report
Zinc levels associated with herpes zoster infection- 1st association reported. Zinc is the second most abundant trace metal in the human body involved in the regulation of innate and acquired immune responses. There is no special zinc storage system so lack of daily zinc supplementation can lead to deficiency. Zinc deficiency is known to cause cellular immune dysfunction which may lead to decreased host response to various infections. Herpes zoster is an acute viral infection caused by the reactivation of latent varicella zoster virus.
Recently a study investigating the serum zinc levels in patients with herpes zoster was published in the Australasian Journal of Dermatology.
The authors compared the serum zinc levels of 13 patients with herpes zoster during a 5-month period from February to June 2021 and 18 preoperative patients as a control group. Espa Zn II (Nipro Co. Ltd., OSA, JP) was used as the zinc reagent, and acid-washed polyspitz (AZZ) was used as the spitz for serum collection.
Results
There was no significant difference in male: female ratio (control vs zoster, 14:4 vs 8:5; P = 0.4328) or age (control vs zoster, 51.56 ± 16.70 vs 59.92 ± 16.59; P = 0.0907) between the two groups. The herpes zoster group had significantly lower serum zinc levels (66.46 ± 13.65 lg/dL; P = 0.0011) than the control group (85.56 ± 15.51 lg/dL). In the control group, there was a negative correlation between age and serum zinc levels (r = 0.5181, P = 0.0276) (Fig. 1b), while there was no such correlation in the herpes zoster group (r = 0.4006, P = 0.1749).
Herpes zoster significantly reduces the quality of life due to its acute symptoms (rash and nociceptive pain), complications (keratoconjunctivitis, meningitis, facial paralysis, deafness and vesicorectal disorder) and sequelae such as postherpetic neuralgia. As the incidence of herpes zoster increases with age, strategies to reduce the incidence of herpes zoster are very important in the ageing society in the future.
The results suggest that serum zinc levels are decreased in patients with herpes zoster, regardless of age. The authors suggest that zinc levels are associated with viral\infection pathogenesis, and that a decrease in zinc levels may be correlated to the pathogenesis of herpes zoster. Though it is unclear whether the decrease in zinc is a cause of herpes zoster or a consequence of herpes zoster. Thus for supplementation of zinc foods with high zinc concentrations like red meat, crustaceans, legumes, fortified cereals and whole grains should be considered. Zinc from animal sources is more bioavailable than zinc from plant sources.
In conclusion, zinc deficiency may be a risk factor for the development of herpes zoster. Zinc supplementation may contribute to the prevention of herpes zoster.
Source-n Akiyama Y, Norimatsu Y, Ohno Y. Serum zinc levels in patients with herpes zoster infection. Australas J Dermatol. 2021 Dec 7. doi: 10.1111/ajd.13756. Epub ahead of print. PMID: 34873681.
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